P103 Infliximab treatment in patients with hidradenitis suppurativa after failure of conventional therapy

Abstract

Many patients with hidradenitis suppurativa (HS) do not respond to standard treatment in England each year and their management is challenging. The NHS does not routinely commission infliximab as evidence on its effectiveness on HS is limited. However, a meta-analysis found that infliximab is effective for treating moderate-to-severe HS, with an overall response rate of 83%. Permission to use infliximab depends on regional or local Individual Funding Request panels. The purpose of this research is to demonstrate therapeutic options for patients with HS after failure of conventional treatment. This unicentric retrospective cohort study assessed the longitudinal development of quality of life (Dermatology Life Quality Index, DLQI) and disease severity (Hidradenitis Suppurativa Area and Severity Index and International Hidradenitis Suppurativa Severity Score System, IHS4) among patients with HS on infliximab at baseline and after 3, 6 and 12 months. The data were extracted from electronic health records (PowerChart™) from 2 July 2008 to 1 December 2025. Descriptive statistical analyses were performed with Python 3.12. In total, 32 patients with severe HS were included in this study, 84% of whom were pretreated with adalimumab. About 60% of the participants were male, and the median age at infliximab initiation was 34 years. After induction, the median frequency was 8 weekly, which was later increased in 56% of patients, while the median weight-calculated dose of 500 mg was not altered among 75%. Efficacy was shown by an improvement of IHS4 in 34% and of DLQI scores in 47% within 3 months of therapy. Eleven patients (34%) developed antibodies against infliximab while on a median infliximab therapy duration of 26.5 months. Overall, 40% of patients adhered to ongoing infliximab therapy, whereas reasons for discontinuation included primary or secondary failure, patient choice and pregnancy. This study demonstrates a quick improvement of severe HS treated with infliximab, with 40% of patients continuing therapy. However, some immunogenicity was observed, as approximately one-third of patients developed antibodies.